Spinal cord injury?

[Sirius Black]

This is the one of the only things I'm have trouble with this semester!

The question came from the practice exam and I'm just wondering if I've answered the question correctly, if I'm way off base, or left anything out.

Quetion =

Explain the consequences of spinal hemisection (i.e. partial transection) at the level of T6 in terms of sensory and motor deficits. Include in your answer the ascending and descending pathways involved.

My answer=

1) Hemisection of the spinal cord will cause loss of movement on the same side as the section, below T6, b/c of the section of the corticospinal and other motor tracts. This means that spastic paralysis of the lower limbs will occur and much of the trunk on the same side as the section.

2) The upper limb on this side will still have movement.

3) Loss of fine touch and vibration sense on the same side as the section below T6, due to section of the dorsal columns, which carry neurons originating from the same side of the body.

4)There will be loss of pain and temperature sensation on the opposite side to the section, below the level of T6 because the spinothalamic tracts carry neurons from the opposite side of the body.

????

:stone

[Daytonite, BSN, RN]

i think, perhaps, that you pretty much described what the symptoms of hemisection are. i used to work on a neuro unit. i believe i saw one patient with a hemisection of the spine very early in my career when i worked on this unit. he had the very unusual symptoms of having a paralysis on one side of their body (the motor deficit) with sensation deficits on the opposite side of their body, or at least that is what i'm remembering. very odd condition. has to do with the anatomy of the spinal cord and the pathway of neurological stimulus. i've been trying to find information on this for you and the closest i am coming is to brown-sequard syndrome or just sequard syndrome. the best information i could find is at this web link http://www.emedicine.com/emerg/topic189.htm near the bottom of the article is a section on brown-sequard syndrome which states this involves injury to only one side of the spinal cord, paralysis, loss of vibration sensation, and loss of proprioceptive input ipsilaterally, with contralateral loss of pain and temperature perception because of involvement of posterior columns and spinothalamic tracts on the same side, and it is associated with hemisection of the spinal cord from penetrating trauma. that is pretty much what you have listed on the answers to your questions. i could find nothing on hemisection in my pathophysiology textbook. i'll leave you to work out the ascending and descending pathways fit into all this.

[Sirius Black]

i think, perhaps, that you pretty much described what the symptoms of hemisection are. i used to work on a neuro unit. i believe i saw one patient with a hemisection of the spine very early in my career when i worked on this unit. he had the very unusual symptoms of having a paralysis on one side of their body (the motor deficit) with sensation deficits on the opposite side of their body, or at least that is what i'm remembering. very odd condition. has to do with the anatomy of the spinal cord and the pathway of neurological stimulus. i've been trying to find information on this for you and the closest i am coming is to brown-sequard syndrome or just sequard syndrome. the best information i could find is at this web link http://www.emedicine.com/emerg/topic189.htm near the bottom of the article is a section on brown-sequard syndrome which states this involves injury to only one side of the spinal cord, paralysis, loss of vibration sensation, and loss of proprioceptive input ipsilaterally, with contralateral loss of pain and temperature perception because of involvement of posterior columns and spinothalamic tracts on the same side, and it is associated with hemisection of the spinal cord from penetrating trauma. that is pretty much what you have listed on the answers to your questions. i could find nothing on hemisection in my pathophysiology textbook. i'll leave you to work out the ascending and descending pathways fit into all this.

thanks.

that site was very helpful.

i think i understand spinal cord injuries a bit better now.

he had the very unusual symptoms of having a paralysis on one side of their body (the motor deficit) with sensation deficits on the opposite side of their body, or at least that is what i'm remembering. very odd condition. has to do with the anatomy of the spinal cord and the pathway of neurological stimulus.

is that d/t the decussation/cross-overs?

[Daytonite, BSN, RN]

Yes, I think so. Odd thing, isn't it?

[Sirius Black]

Yes, I think so. Odd thing, isn't it?

It is - and interesting. Even though I found spinal cord injuries difficult to understand at first, I enjoyed learning about SCI too!